Happy Birthday BOTOX® – You don’t look a year older!

Botox®. Over the past two decades, it’s been injected into the fabric (and faces) of our society. You’d be hard pressed to find anyone who hasn’t heard of it, had it or wanted it. Even after 20 years, Botox® is still the most popular cosmetic procedure nationwide according to the American Board of Cosmetic Surgery. And it’s easy to see why. Not only are Botox® injections a quick, virtually painless procedure, they can take years off in minutes without changing the overall look and structure of the face. They can address deeper lines or be used to prevent them in the first place. But while most everyone is familiar to some degree with Botox®, we wanted to dive a little deeper, answer any remaining questions you may have and dispel any myths you may have heard. So let’s talk ‘tox.

Let’s begin with the basics… what exactly is Botox®? By definition, it’s a specific brand of neuromodulator (Clostridium botulinum) that is injected into specific muscles to temporarily block their nerve receptors in order to immobilize the movement that creates lines and wrinkles, thereby keeping them from forming or getting deeper. It can be used on many areas of the face (the most popular and well-known uses) but can also be used to address things like muscle spasms and stiffness, TMJ and tooth grinding, overactive bladder and excess sweating, even migraines and depression.

And while Botox® is still the most recognizable name in neuromodulators, it’s not the only one. However, it is responsible, in great part, for launching and establishing the non-invasive aesthetic industry and has inspired the creation of other neuromodulator products. You may have, more recently, heard the names Dysport, Xeomin and Jeuveau thrown around…these are all brands of neuromodulators that we carry and use at W, all of which create a similar result: Smoother, more youthful skin with less lines.

So now that you know what they are, let’s discuss how they’re used. Neuromodulators help to address variety of skin and aging concerns, including forehead lines, glabella/frown lines (also called “11s”) and crow’s feet or smile lines. These are probably the most widely recognized and popular facial uses, but did you know that Botox® (or any of its neuromodulator counterparts) can also be used to treat a gummy smile, fine lines on the upper lip (or create a “lip flip”), neck (platysmal) bands, jawline laxity, bunny lines (upper nose between the eyes), jelly rolls (under eye area), “peach pit” chin and so much more. Botox® can literally refresh, lift and transform the whole face while still keep you looking like you. In addition it can also be used to treat non-cosmetic concerns such as the clinical medical issues (like muscular spasms, TMJ and migraines) listed above.

But while it has so many uses and benefits and has been safely performed for almost two decades, there is still a lot of misinformation surrounding Botox® injections. Here are just a few myths we want to address and dispel.


Myth 1: Neuromodulators are dangerous or unsafe.

Botox® as a cosmetic procedure to treat wrinkles was FDA approved in the spring of 2002 and has been used safely for 20 years. With over 6 million doses injected every year, it has become a tried, tested and safe treatment when administered by a trained professional.


Myth 2: Botox® will make you look frozen or unnatural.

While there have obviously been cases where Botox® is overused or misused by unqualified injectors, when performed by an experienced and highly-trained injector (like all of our skilled W nurses), you’ll get a very natural result. At your first appointment, we will consult with you about the areas you want to address, and we err on the side of conservative at your first Botox® visit in order to make sure you look natural and are happy with your results. We can always add more later if that’s your desire. Also, while we strive to give you the absolute best result possible, the great news about neuromodulator is that it does gradually dissipate over the course of 3-4 months, so if you ever feel that you lack movement or are not fully satisfied with the result, it’s not permanent and will correct on its own with time.


Myth 3: Botox® is only used for cosmetic purposes.

As mentioned, the most well known uses for Botox® are cosmetic, but neuromodulators have been used with great success to treat other non-aesthetic concerns as well, including alleviating the symptoms and pain of migraines and TMJ, and to curb excessive sweating, helping to lessen self-consciousness and increase confidence. In fact, in 1989 (before it was ever FDA approved for cosmetic use), Botox® was approved to help address two eye muscle disorders.


Myth 4: Neuromodulators are only for women.

While women do still make up the majority of Botox® patients, these injections (and cosmetic procedures in general) are growing in popularity among men as well. In fact, some aesthetic practices report that 20-30% of their neuromodulator patients are male. Like women, the most common injection sites among men are the forehead, glabella (frown lines) and crow’s feet. At W, we love treating both women and men (and stay tuned because we have something special coming just for men in the near future.)


Myth 5: Results are immediate.

Unlike filler which does offer immediate results by adding volume, Botox® takes a minute (well technically, a few days to two weeks) to kick in. Timing does vary a bit based on the individual neuromodulator but, in general, results can begin to be seen as early as 3-5 days post-injection. Also, keep in mind that different areas react differently and results may start to be visible in one area sooner than another. However, full results in all treated areas should be noticeable by two weeks after your visit.


Myth 6: Botox® treatment and results are the same for everyone.

Like all of our services at W, Botox® is a personalized treatment. There is no set formula for how many units an individual should get or how often. In fact, it may not even be Botox®, but rather one of the other neuromodulator options, that works best for you. However, as a general rule, we suggest treatments every 3-4 months to maintain results, keeping in mind that everyone metabolizes  neuromodulator differently. So while one person may be able to go 4 (or even 5) months between treatments, others (especially those who are very active) may need to come back more often or receive more units per treatment to maintain their results. Likewise, neuromodulator kicks in at different rates and affects everyone differently. Some may notice a change right away, some may need more (or fewer) units to see results and some (though it’s rare) may even be Botox®- resistant.



So now that you know what it is and what it’s not, here’s what you can expect when it comes to your neuromodulator appointment at W. First we will consult with you to discuss your individual concerns and the areas you’d like treated. We’ll talk about the different neuromodulator options and their nuances, and together decide what’s best to give you the best result.

Neuromodulator injections are quick and virtually pain-free so you can expect your appointment to last approximately 30 min. However, if it’s your very first appointment with us, we do schedule a little extra time to make sure we are able to fully discuss and understand your goals, spend the necessary time with you to achieve them and aren’t ever rushing to complete your visit. At the end of your appointment we will give you post-care instructions, but as a quick overview, here are a few things you should and shouldn’t do after neuromodulator:

  1. For the first 4 hours: No hats, no laying flat (we don’t want anything to migrate), no rubbing or massaging the areas and no makeup (this is to allow the tiny injection sites to close so that there is no risk of irritation or infection).
  2. For the first 24 hours after: Avoid strenuous exercise (walking is fine) and we also recommend that if you tend to bruise, avoiding alcohol and ibuprofen for a day is also a good idea.
  3. If you do have any bruising at the injection sites it should be minor, but feel free to take an arnica supplement or use topical arnica gel or cream on the area(s).

Chances are, you’ll walk away from your appointment with few to no obvious signs that you’ve had an aesthetic treatment. Occasionally you may experience minor swelling at the injection sites but that usually dissipates within the hour. There is always a risk of bruising with any injectable treatment, however because Botox needles are very small and most is injected more superficially (versus deep into the skin), chances of bruising are typically less than other injectables such as filler. But if you are prone to bruising, we recommend that you prep for your Botox appointment by avoiding alcohol and ibuprofen for at least a few days prior and begin taking an arnica supplement 5-7 days before. In addition, if you’re prepping for a big event (think wedding, black tie party, photo session etc), we encourage you to plan ahead and schedule your neuromodulator appointment at least two weeks prior. We want to help you look your best with no worry about bruising or not achieving your full results in time!

All that to say, if you’re new to aesthetic treatments, Botox® (or one if its counterparts) is a perfect way to ease your way in, giving you the ability to see a subtle and youthful difference without downtime or drastically changing the way you look. It’s one of those treatments that gets people asking, “You look great! What’s your secret?” (You can just tell them you’ve been on vacation or getting great sleep… or you can let them in on the W secret, it’s up to you.)

If you have any additional questions about neuromodulators or what to expect at your W appointment, give us a call. We love the ‘tox and what it can do (check out before and afters on our Instagram, including one full face transformation done completely with neuromodulator!) and we can’t wait to help you achieve beautiful Botox® results too.